Navigation Links
Evidence insufficient to recommend routine antibiotics for joint replacement patients
Date:12/18/2012

Rosemont, Ill. - The American Academy of Orthopaedic Surgeons (AAOS), and the American Dental Association (ADA) found that there is insufficient evidence to recommend the routine use of antibiotics for patients with orthopaedic implants to prevent infections prior to having dental procedures because there is no direct evidence that routine dental procedures cause prosthetic joint infections.

The AAOS and ADA's recommendations are based on a collaborative evidence-based clinical practice guideline that focuses on the possible linkage between orthopaedic implant infection and patients undergoing dental procedures.

"As clinicians, we want what is in the best interest of our patients, so this clinical practice guideline is not meant to be a stand-alone document. Instead it should be used as an educational tool to guide clinicians through treatment decisions with their patients in an effort to improve quality and effectiveness of care," said David Jevsevar, MD, MBA, chair of the AAOS Evidence Based Practice Committee which oversees the development of clinical practice guidelines.

"It has been long debated that patients with orthopaedic implants, primarily hip and knee replacements, are prone to implant infections from routine dental procedures," added Dr. Jevsevar who also is an orthopaedic surgeon in St. George, Utah. "What we found in this analysis is that there is no conclusive evidence that demonstrates a need to routinely administer antibiotics to patients with an orthopaedic implant, who undergo dental procedures.

  • In 2010, there were more than 302,000 hip replacement and 658,000 knee replacement procedures performed in the United States.[1]

  • Infections can occur when foreign organisms enter the wound during or at any point following joint replacement, and can lead to additional surgery and prolonged antibiotic treatment.[2]

  • For studies of hip and knee included in this guideline, the mean rate of infection was 2 percent.[3]

Elliot Abt, DDS, MS, MSc, who served as member of the AAOS-ADA work group on behalf of the ADA, pointed out that the review committee conducted a thorough review of existing clinical research published in the peer-reviewed literature.

"This guideline was based primarily on clinical research which examined a large group of patients, all having a prosthetic hip or knee and half with an infected prosthetic joint," said Dr. Abt, a general dentist in Skokie, Ill., and a member of the ADA Council on Scientific Affairs. "The research showed that invasive dental procedures, with or without antibiotics, did not increase the odds of developing a prosthetic joint infection."

This clinical practice guideline, with three recommendations, is based on a systematic review of the correlation between dental procedures and prosthetic joint infection (PJI).

  • Recommendation one, which is based on limited evidence, supports that practitioners consider changing their longstanding practice of prescribing prophylactic antibiotics for patients who undergo dental procedures. Limited evidence shows that dental procedures are unrelated to PJI.

  • Recommendation two addresses the use of oral topical antimicrobials (topical antibiotic administered by a dentist) in the prevention of PJI in patients undergoing dental procedures. There is no direct evidence that the use of oral topical antimicrobials before dental procedures will prevent PJI.

  • Recommendation three is the only consensus recommendation in the guideline, and it supports the maintenance of good oral hygiene.

"Research is always changing and we need to work to improve clinical research databases, so in the future any type of prospective research done in this area will help shed light on prophylaxis and orthopaedic infection rates," Dr. Jevsevar said.


'/>"/>

Contact: Lauren Pearson Riley
pearson@aaos.org
847-384-4031
American Academy of Orthopaedic Surgeons
Source:Eurekalert

Related medicine news :

1. Researchers find evidence of banned antibiotics in poultry products
2. Report says new evidence could tip the balance in aspirin cancer prevention care
3. More Evidence Bilingualism Aids Thinking Skills
4. Novel biomarkers reveal evidence of radiation exposure
5. Antiretroviral treatment for preventing HIV infection: an evidence review for physicians
6. WSU study finds overwhelming evidence of hidden heart disease in hypertensive African-Americans
7. Study shows no evidence medical marijuana increases teen drug use
8. Study of Retired NFL Players Finds Evidence of Brain Damage
9. New evidence for link between obesity and circle of friends
10. Cochrane finds no reliable evidence on effectiveness of electric fans in heatwaves
11. Study Gives First Evidence That Adult Human Lungs Can Regrow
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:6/25/2016)... ... June 25, 2016 , ... As a lifelong Southern Californian, ... and his M.D from the David Geffen School of Medicine at UCLA. He trained ... Angeles to complete his fellowship in hematology/oncology at the UCLA-Olive View-Cedars Sinai program where ...
(Date:6/24/2016)... Angeles, CA (PRWEB) , ... June 24, 2016 , ... ... surgery procedures that most people are unfamiliar with. The article goes on to state ... procedures, but also many of these less common operations such as calf and cheek ...
(Date:6/24/2016)... , ... June 24, 2016 , ... ... and Scientific Sessions in Dallas that it will receive two significant new grants ... grants came as PHA marked its 25th anniversary by recognizing patients, medical professionals ...
(Date:6/24/2016)... ... 24, 2016 , ... Topical BioMedics, Inc, makers of Topricin and MyPainAway Pain Relief Products, join ... wage raise to $12 an hour by 2020 and then adjusting it yearly to increase ... of the minimum wage, assure the wage floor does not erode again, and make future ...
(Date:6/24/2016)... Nevada (PRWEB) , ... June 24, 2016 , ... ... Vegas client, The Grove Investment Group (TGIG), has initiated cultivation and processing operations ... in Las Vegas and Pahrump, Nevada. , Puradigm is the manufacturer of a ...
Breaking Medicine News(10 mins):
(Date:6/24/2016)... SOUTH SAN FRANCISCO, Calif. , June 24, ... GBT ), a biopharmaceutical company developing novel ... with significant unmet needs, today announced the closing ... 6,400,000 shares of common stock, at the public ... the shares in the offering were offered by ...
(Date:6/24/2016)... 24, 2016 ... the addition of the " Global Markets for ... This report focuses on ... updated review, including its applications in various applications. The ... which includes three main industries: pharmaceutical and biotechnology, food ...
(Date:6/24/2016)... ALEXANDRIA, Va. , June 24, 2016 ... a set of recommendations that would allow ... information (HCEI) with entities that make formulary and coverage ... determine the "value" of new medicines. The ... that does not appear on the drug label, a ...
Breaking Medicine Technology: